Rehabilitation program for upper limb injuries in military personnel

Objective: development and evaluation of the effectiveness of using a set of exercises for therapeutic gymnastics for mobilization and stabilization of joints in medical rehabilitation programs for military personnel with upper limb injuries. Material and methods. The study involved 45 patients with upper limb injuries who were treated at the Department of Traumatology and Orthopedics of the Federal State Budgetary Institution «301 Military Clinical Hospital» of the Ministry of Defense of the Russian Federation, Khabarovsk, including after surgical stabilization of the joints of the upper limb. Depending on the medical rehabilitation programs used, all patients included in the study were randomized into 3 groups: Group 1–15 military personnel who, along with basic therapy (laser therapy, magnetic therapy), underwent therapeutic gymnastics according to the generally accepted method; Group 2–15 servicemen who, along with basic therapy (laser therapy, magnetic therapy), underwent a specially developed set of exercises for therapeutic gymnastics for mobilization and stabilization of joints; Group 3–15 servicemen who, along with basic therapy (laser therapy, magnetic therapy), a set of exercises for therapeutic gymnastics for mobilization and stabilization of joints, underwent training on the Orthorent Motorika device (RF). To assess the effectiveness, all patients underwent the following before and at the end of treatment: goniometry in the shoulder-scapular joint; shoulder assessment questionnaire SSI-ASES (Shoulder assessment form American shoulder and elbow surgeons); Shoulder assessment scale (The University of California — Los Angeles (UCLA) Shoulder Scale); Constant-Murley scale (CMS). Results. Taking into account the knowledge of pathobiomechanical processes, a set of exercises for therapeutic gymnastics for mobilization and stabilization of joints was developed, aimed at relieving tonic muscle tension in the involved muscles, reducing pain syndrome, increasing the volume of active movements in the joints of the upper limbs in combination with traditional physiotherapeutic treatment. The maximum effectiveness of treatment was achieved with an integrated approach combining physiotherapy, specialized gymnastics and hardware coordination training, which was confirmed by a decrease in pain intensity by 45 %, an increase in the amplitude of movements by 31–37 %. Conclusion. The obtained results have important practical significance for the development of optimal rehabilitation programs. They indicate the need to combine various therapeutic approaches and the importance of consistently increasing the intensity and complexity of rehabilitation measures to achieve maximum clinical effect.